Florida Regulations 65C-2.007: Fees for Services
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(1) Priority for services is based on need for services combined with the income level of the prospective client. First, eligibility must be determined through the administration of the APS Screening for Consideration for Community-Based Programs, CF-AA 1022, 10/2009, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-13318, and verification of the client’s income. If the income is above the existing institutional care program eligibility standard, then a fee for services will be assessed based on the client’s care plan. Once an applicant is deemed eligible and a priority candidate for services, a determination shall be made as to an amount that the applicant will be charged for those services based on an overall ability to pay. Partial payments may also be assessed.
(2) The case service manager shall request information from the applicant or his spouse, relative or guardian if needed, as follows:
(a) Monthly income to include all earnings, payments and pensions to the applicant. Assets are not included.
(b) Expenses to include housing and utilities, telephone, food, medical expenses, transportation and insurance.
(c) Necessary monthly expenses as defined in subsection (b), shall be subtracted from monthly income as defined in subsection (a), to determine the applicant’s disposable income and overall ability to pay. Applicants who have $200.00 or more remaining after expenses are subtracted shall be assessed a fee, as provided in subsection (d), and requested to pay toward the cost of service he receives.
(d) The applicant will be asked to pay 10 percent of his disposable income or the unit cost of the service he is to receive, whichever is less. The unit cost will be determined from the most recent unit cost report of the provider or the fixed rate charged in a contract.
(3) In those situations where the applicant is currently receiving a service on a private pay basis and can continue to pay for the service, the applicant shall not receive the service under state Community Care for Disabled Adult funds. If the service is available on a private pay basis from another agency and the client assessment has determined that the applicant can pay for the service, then the applicant shall be referred to the other agency for the services. However, if the applicant is able to pay for a service, but the service is not available from any other agency, then the Community Care for Disabled Adults provider shall provide the service, inform the applicant of the dollar amount or in-kind service, and require such fee toward the cost of the service. If the client is unwilling to pay the assessed fee or contribute the in-kind services of specific value, services shall be denied.
(4) Clients shall have the opportunity to perform volunteer services in lieu of making payments.
(5) At the time the ability to pay is determined, the applicant shall attest to the truthfulness of the financial status submittal by signing a sworn written statement.
(6) Client payments shall be directed to the provider and may be used to expand the Community Care for Disabled Adults program.
(7) Redetermination of a client’s ability to pay shall be on an annual basis. The client may request redetermination based upon a change of financial status.
Rulemaking Authority 410.606 FS. Law Implemented Florida Statutes § 410.604. History-New 1-24-89, Amended 6-24-96, Formerly 10A-16.007, Amended 12-8-98, 7-27-21.
Terms Used In Florida Regulations 65C-2.007
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Contract: A legal written agreement that becomes binding when signed.
- Fixed Rate: Having a "fixed" rate means that the APR doesn't change based on fluctuations of some external rate (such as the "Prime Rate"). In other words, a fixed rate is a rate that is not a variable rate. A fixed APR can change over time, in several circumstances:
- You are late making a payment or commit some other default, triggering an increase to a penalty rate
- The bank changes the terms of your account and you do not reject the change.
- The rate expires (if the rate was fixed for only a certain period of time).
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
(a) Monthly income to include all earnings, payments and pensions to the applicant. Assets are not included.
(b) Expenses to include housing and utilities, telephone, food, medical expenses, transportation and insurance.
(c) Necessary monthly expenses as defined in subsection (b), shall be subtracted from monthly income as defined in subsection (a), to determine the applicant’s disposable income and overall ability to pay. Applicants who have $200.00 or more remaining after expenses are subtracted shall be assessed a fee, as provided in subsection (d), and requested to pay toward the cost of service he receives.
(d) The applicant will be asked to pay 10 percent of his disposable income or the unit cost of the service he is to receive, whichever is less. The unit cost will be determined from the most recent unit cost report of the provider or the fixed rate charged in a contract.
(3) In those situations where the applicant is currently receiving a service on a private pay basis and can continue to pay for the service, the applicant shall not receive the service under state Community Care for Disabled Adult funds. If the service is available on a private pay basis from another agency and the client assessment has determined that the applicant can pay for the service, then the applicant shall be referred to the other agency for the services. However, if the applicant is able to pay for a service, but the service is not available from any other agency, then the Community Care for Disabled Adults provider shall provide the service, inform the applicant of the dollar amount or in-kind service, and require such fee toward the cost of the service. If the client is unwilling to pay the assessed fee or contribute the in-kind services of specific value, services shall be denied.
(4) Clients shall have the opportunity to perform volunteer services in lieu of making payments.
(5) At the time the ability to pay is determined, the applicant shall attest to the truthfulness of the financial status submittal by signing a sworn written statement.
(6) Client payments shall be directed to the provider and may be used to expand the Community Care for Disabled Adults program.
(7) Redetermination of a client’s ability to pay shall be on an annual basis. The client may request redetermination based upon a change of financial status.
Rulemaking Authority 410.606 FS. Law Implemented Florida Statutes § 410.604. History-New 1-24-89, Amended 6-24-96, Formerly 10A-16.007, Amended 12-8-98, 7-27-21.